Dr. Stephen Ponder, an endocrinologist living with type 1 diabetes, has been posting thought-provoking questions on Facebook. One of the latest questions was: “How often do you say “good” or “bad” when talking about blood sugar (or an A1C)? If not, then how do you describe them? Should kids use “good” and “bad” when talking about their sugar levels?”

I thought I’d answer in the form of a blog post since this sparked a whole long train of thought for me.

Confucious supposedly said, “The beginning of wisdom is to call things by their proper name.” If something causes you harm–for example, as high blood sugar does, then I hesitate NOT to call it a “bad” blood sugar because it simply is, whether we acknowledge it or not. I believe it would be bad for my health if I didn’t identify, accept, and name the truth on a regular basis. It’s hard to swallow but my reality needs to be very much imposed on me if I am to act in my best interest.

Houston: We Have a Problem

People email me all the time asking what the secret is to my pretty good diabetes management and how I have the discipline for it. Honestly, any good I derive from my actions begins with calling things by their proper name. That means that I admit that eating what I want and covering it with insulin doesn’t work well enough (for me). I openly say that low carb for type 1 diabetes is the only way I know of, to get close to achieving normal blood sugar levels, a healthy weight, and safety from severe hypoglycemia. And I say that not having normal blood sugar levels is physiologically harmful because we know it is. If it weren’t, no one would be diagnosed with pre-diabetes with a 6% A1c level but, they are every minute of every day. It is on that basis that I call a 6.5% harmful and deem it not good enough for me.

If I don’t acknowledge that something is “bad” or “not good” then I don’t follow with the appropriate response or actions which have to do with changing those blood sugars or anything else. We need to apply judgment in our daily lives. It’s necessary. I have to be able to admit to myself when I’ve mistreated a loved one or I’ll certainly continue to do it. I have to be able to admit when I’m overeating, or I’ll keep gaining weight. And I have to be able to say “no, that’s not good for me” or I will suffer various potentially unlimited consequences. What is it they say to those with an addiction? “You must first admit there is a problem.”

High Blood Sugars Make You Feel Bad Even if You’re Told Not to Feel Bad

I understand parents of children with diabetes don’t want to use “good” and “bad” in relation to blood sugars or diabetes management in part because the child didn’t have anything to do with getting such a brutal condition and we don’t want them to feel bad about themselves due to diabetes. And I do support the effort many parents put into saying things like, “It’s not that you did anything bad, it’s that this isn’t working and we need to figure out what will work better.” There is still an acknowledgment that something isn’t working and the troubleshooting can begin and the child can feel better, physically, mentally, and emotionally.

I’ve recently put quite a bit of thought into why I struggle to do what I needed to as a kid with diabetes. There are several reasons but I think the main one is that doing what my parents and I were told to do didn’t ensure my success, at all, and made me feel sick and anxious anyhow and thus I acted out of hopelessness, by lying about my blood sugars, not always doing my blood sugar testing, and sneaking sugary foods to self-medicate my feelings of despair. I knew what my high blood sugars meant for my future, and in the immediate moment, my self-esteem took a hit. High blood sugars (especially really high blood sugars) make you extremely sluggish, make your saliva thick and foamy, your thinking slow, and make you not look and feel generally healthy (albeit subtly, at first).

Let’s face it, anything that is a detriment to health is a detriment to outwardly attractiveness, if not now, then later. I remember thinking as a teen that I was totally ok with my ears sticking out–there was nothing I could do, and they functioned properly, but I wasn’t ok with the weight gain I was experiencing from the way my diabetes was being managed. I wasn’t ok with becoming less attractive due to diabetes nor slower as I played sports which requires you to compete using your energy and speed. I couldn’t prove to myself or anyone else how just how good I could be as I couldn’t fully apply myself to anything. Within my capabilities, I tried SO hard, though. Not getting results for your efforts because of diabetes makes a person crazy. And successful diabetes management relies on the most effective efforts, not the most industrious ones so I lost out.

For those without diabetes, think of how you feel about yourself when you’ve been injured or come down with a bad cold–you’re knocked down a few pegs, right? Even if people are kind to you and don’t make you feel bad about any of it. Admit it, you feel less attractive, less productive, and you may feel motivated to do whatever it takes to get yourself back to feeling good, even doing things that you were not willing to do before that experience.

I believe many people with diabetes, including children, are in an impossibly precarious situation when their blood sugar management is less than ideal. This is particularly true once they learn what elevated blood sugars can do to them over time or once the negative effects stack up over the years. No, it’s not fair, or whatever, but all I know is my “good” diabetes management began when I admitted to myself that my diabetes management was “bad” and that if I were willing to make some sacrifices in the name of tight blood sugar management, I may have a ticket to health and happiness. It’s been more than worth it, which is why I keep annoyingly banging this tired drum.

Is it Possible to Do Better?

I am partial to diabetes management for adults and children which makes it easier for them to be successful with their diabetes because the alternative leads to misery. No matter how much you tell a person they are “good,” if their blood sugar levels are often high, they are going to be feeling poorly much of the time, and that is going to make them feel “bad,” regardless. It’s very hard for us to separate how we feel, physically, from how we feel, mentally. One follows the other. Feeling unhealthy does not lend itself to feeling good and it never will.

Do some people who don’t feel healthy manage to feel good and happy? Yes, but this is a feat not accomplished by most, and while children amaze us with their resilience alas, they do grow up, and many will suffer the weight of high blood sugars and blood sugar variability and fear of hypoglycemia as evidenced by personal social media accounts and all the studies pointing out rates of anxiety and depression in adults with type 1 diabetes.

This is why I encourage the attempt at a low carb diet for anyone with type 1 diabetes. Thanks to those who do very low carb diets, we’ve learned that it is possible to do better with glycemic control. Did you know that for a long time no one did better than a 4-minute mile and experts said it was impossible and once Sir Roger Bannister did, many others followed suit soon after? That’s because we can only accomplish what we believe is possible. I’m telling you that I’m not special, I don’t have more discipline than you, and that it is possible to achieve very tight and safe, blood sugar control.

The repercussions of this are incredible. In my experience, it leads to better moods, better relationships, improved ability to work, less fear of highs and lows, less anxiety, less depression, better sleep, and on and on. The positive effects are hard to quantify but they are exponential and eventually make going back to another way of managing diabetes something I won’t consider.

You can’t easily feel good about yourself if you don’t feel good physically and you likely can’t feel your best physically if you don’t have blood sugars as close to normal as possible. For more: check out the Sir Roger Bannister of the type 1 diabetes world: Dr. Richard K. Bernstein.

To conclude, I don’t worry about good/bad and any similar terminology when I think to myself, I worry mostly about my outcomes and my actual experience. It’s surprising how happy I can be while honestly telling myself that something is “bad”. That’s because I then put my energy into finding what makes it “good” and focus on that, instead. What you focus on matters and makes all the difference.

(If you manage your blood sugars well without low carb and you’re happy and healthy, I’m not directing this to you, at all.)

My colleague at Diabetes Daily, Maria Muccioli, Ph.D., wrote an excellent and in-depth coverage of a remarkable study on very low-carb diets for treating type 1 diabetes in children.

The study found that a group of type 1 diabetic children following a very low-carb diet à la Dr. Bernstein style were not only experiencing normal blood glucose levels (this is nearly unheard of in type 1 diabetes) but also growing well (a top concern as macronutrient intake of carbs is widely believed to be essential for growth in children).

The researchers of the study looked at children from a Facebook group called Type1Grit. This group consists of adults with type 1 diabetes and parents of children with type 1 diabetes who all follow Dr. Bernstein’s regimen. This regimen includes very low-carbohydrate intake but so much more–put just any type 1 diabetic on a very low-carb eating plan, and I promise you’ll likely not get the results you are hoping for–though if you pay close attention to blood sugars you may notice some interesting things regarding the statistical range of error after giving smaller amounts of insulin. It’s about more than low-carb eating. Low-carb is essential to the plan but to do well, there are more things to do and understand. One must understand how to use and adjust insulin properly, understand how different physical activity impacts blood sugars, and so on. The Type1Grit group does so well because they utilize Dr. Bernstein’s decades’ long expertise to guide them (which is all in his book) and like any good support group, they help each other stay focused, informed, and motivated.

Some people on social media have voiced strong opinions against the group due to some of their outspoken members. It is my hope that we focus on content over delivery when it comes to important matters. After all, if fellow thinkers had rejected Issac Newton’s findings simply because he was a jerk (and according to the book I’m reading my kids about him he was) wouldn’t that be a shame? Personally, I strive to be gentle with others because I am quite sensitive. However, I also try not to put my feelings above critical thinking, and I think that serves me well. I also hope that the communication of a few doesn’t cause some to dismiss the whole group or worse–a promising idea. That said, I have not personally observed anyone from that group being rude to others, though some have been quite open and blunt with their opinions and I have observed a very strong response to that, in general. I do not consider an opinion shared in a straightforward manner to be rude.

My Personal Story Following Dr. Bernstein’s Advice

I have followed a loose version of Dr. Bernstein’s protocol for about a decade, further lowering carbs and adding in more of his advice gradually over the years (I now follow his advice very closely). His logic struck me like lightning when I read his book, Dr. Bernstein’s Diabetes Solution. In particular, I was deeply moved by a line that said something about how people with type 1 diabetes “deserve normal blood sugars”. Dr. Bernstein’s protocol includes the use of Regular insulin to cover high protein meals versus faster analog insulin such as Humalog or Novolog. In fact, after using a CGM (continuous glucose monitor) for the first time recently, I quickly saw how my Humalog was a bit too quick and potent at mealtime and then a bit too short hours afterward, so I bought Novolin R at Walmart for $24 and have improved my blood sugar levels. This is to stress how following Dr. Bernstein’s protocol is about more than just reducing carbohydrate intake.

Many years ago, I found immense value in attempting just a little bit of Dr. Bernstein’s advice. Small changes like lowering my carbohydrates and understanding how to use my insulin better led my A1c to drop from 8-9% down to 6%. Before this, just covering high amounts of carbohydrates with insulin had mostly succeeded in making me fat, tired, depressed, and anxious (oh and with protein spilling into my urine as an 18-year-old in her “prime” of life). You have to understand how terrible this was for me–I was a bright-eyed kid who was intelligent, hopeful, hardworking, patient, and super determined. In a few short years, diabetes messed with my potential–I didn’t recognize myself anymore. It’s particularly sad to spend years recovering as a young adult when you’re supposed to be at peak performance and potential due to your youth and energy.

Dr. Bernstein, who many dare call a “quack” or “nutjob” saved my life just as he saved his own. My A1c hasn’t touched 6% in many years. I have a wonderful husband. We have twins who are about to turn 9. I’m still trying to reverse some of the consequences of very high blood sugars from my first 10-12 years with diabetes. What if I didn’t have to?

What Actually Does More Harm?

People tell me that eating low-carb will hurt my cognitive abilities. Do they know that studies indicate that typically managed type 1 diabetes may do that, anyway? Type 1 diabetes (with the average management of 8.2% A1c in the U.S.) has been shown to possibly lower intelligence and negatively affect memory and speed. Low-carb in the long-term may hurt my cognitive abilities (I haven’t seen anything to indicate this possibility though) but what if it just takes the place of what high blood sugars would have done to my cognition? And what if low-carb additionally helps protect my cardiovascular health and my kidneys and my eyes–oh and allow me to have healthy children! Do you know how fortunate I am that I turned things around when I did? I have children because of the information that turned my health around just in the nick-of-time. I can’t begin to describe the level of rage I might have had I never had children yet discovered that Dr. Bernstein has been trying to tell the world about his successful method for decades.

Where is Our Curiosity?

If you find Dr. Bernstein followers as angry or overly-passionate, this may help explain why: Unnecessary suffering is a tragedy. We’re in a country whose founders had been curious and open to acknowledging ideas that are worthy, pushing those ideas to the top where they can be put to the test and then accepted as the best ideas because they can create the best outcomes. This is the great thing about Western Civilization. The embracing of objective principles which allow the best ideas to rise because even if they come from someone we can’t stand, we know that ideas, critical thinking, and truth reign over all else and push us towards progress. Dr. Bernstein’s protocol isn’t an expensive training center and it’s not just for the elite of the world. He thrives using a cheap insulin in the same country where people die because they don’t know they can change their dietary habits and purchase cheap over-the-counter insulin in most states and survive.

From an economic and financial viewpoint, Bernstein’s protocol is also a stunning success. I don’t use an insulin pump or a CGM (I only got to test one out) and yet I can achieve my glycemic targets. I don’t need any apps, certified diabetes educators, or expensive technology. I don’t anxiously await a closed-loop hybrid insulin pump system because I don’t need it. I put all my energy into my simple but effective daily lifestyle. Providers who want to see healthier patients, please read Bernstein’s book. Your lower income patients may not want to follow the regimen in part or entirely but those who are willing deserve to know how to thrive with diabetes despite being poor or lower middle class, like me. I give myself excellent care for cheap–doesn’t that peak your interest?

People are justifiably angry over insulin prices but what about the medical community’s unwillingness to be curious about one doctor’s personal plan to keep himself at peak health and fitness well into his 80s? Without curiosity, what on earth then drives a doctor to investigate the issues in each patient as well as find the proper and least harmful solution? I tell my doctor how I managed a huge drop in A1c for the first time in my life and he has no questions regarding how I did it? I read doctor responses to research that shows a teeny tiny improvement in A1c and now they think “this shows wonderful promise and we should look into it further!”? I basically told my doctor I might have just saved my own life and drastically improved my quality of life, and he’s like “meh”. I told another how I did it and he said, “good for you.” Yes, good for me, but what about some of your patients who are as I was, struggling to get a halfway decent hold on their blood sugar and suffering? What about them? Don’t you have an obligation to check this out? This gives my doctor less work, by the way! For a decade now my doctor does nothing to manage my diabetes–he just orders labs. Aren’t doctors wanting more patients that can manage their blood sugars and don’t need them so desperately at all hours?

It Takes “Too Much Discipline” or “Restraint”

Nothing terrible ever happened by being disciplined. Think of all the amazing people out there and from history–what could they have accomplished without discipline? Probably nothing but a few moments of greatness. Discipline encompasses you within a realm of potential greatness. And if you create a system, discipline isn’t a show of willpower as much as you just loyally following your regular routine.

Much research backs up the potential of the ability to defer gratification. Who is more likely to become successful? The person who can restrict themselves from their impulses and short-lived desires, right? Let me put it this way: who would you rather marry? Someone who can keep their impulses in check or someone who can’t? Or who would you rather be? Someone who doesn’t overeat or someone who regularly does? I remember having hearts in my eyes when my husband told me “I never overeat”. I have long struggled with overeating, and when he said this, I was impressed by him and thought, “wow, I want to be like that.” I believe this is the empowered response. I could have given the common humorous response of “ugh, you make me sick” but where would that have gotten me? Instead, I tried to learn from my husband and improve myself.

I also think the healthy response is to admire someone like Dr. Bernstein for what he has accomplished against great odds. Dr. Bernstein is respected by so many because he created a well-functioning system to get himself thriving and generously shared his findings with others. In fact, as an engineer, he became an endocrinologist so that he could help others after he figured out how to save himself. He should be regarded as an American hero, whether you want to do what he recommends or not.

I believe in freedom and personal rights. I’m an immigrant who is incredibly happy to live in the U.S. Growing up when I found something challenging and I didn’t want to face it, my dad would say “Are you an American or an American’t?” I would often roll my eyes but, yes, I’m an American and believe I have the power to set my mind to improve myself if I want and I’m grateful for those who have set their minds to things and laid out paths before me. Thank you, Dr. Bernstein. I may never reach your astounding level of discipline but what I have been able to achieve with your advice has been most valuable to me and my family and I am forever grateful.

En fin, I’m certainly not saying you should do what he does or what I do. And I can respect wherever you are on your journey. I’m saying that Dr. Bernstein’s method has shown undeniably incredible potential and results and the general lack of curiosity and investigation on behalf of the global medical community makes absolutely no sense to me. There are now thousands of people doing it and doing it well.

Newton supposedly struggled with his ego and an inability to face criticism or questioning during his lifetime. Let’s have his overwhelming curiosity without the pride, his determination to dig and experiment properly without his emotionally unstable and anti-social ways.

I will leave you with one more thought:

Just a little bit less damage sustained is a great deal to the person enduring it, especially when they still have many decades ahead of them.

Most of what I do is share information regarding diabetes news and a great deal of that is comprised of studies that effectively help us learn more about the effects of diabetes on our bodies.

If it depresses or overwhelms you to read this types of news, believe me, I completely understand. I felt sick for the first few months of doing this kind of writing because every piece of what seemed like bad news gave me a strong negative physical reaction. I quickly realized I needed to do two things: compartmentalize and use actions to attack my fears.

What many of these studies iterated to me was that I needed to find a way to avoid as many high blood sugars as I could. One of the reasons I feel so strongly about this is that I’ve already dealt with the negative effects of prolonged high blood sugars and if I had been diagnosed last year, I’d likely feel a little less motivated to employ some serious interventions. Yet, maybe not, who knows.

Time and too many high blood sugars has taken it’s toll and I must fight to win back as much health as is humanly possible. I’m stubborn, as I’ve said before many times, and I want not just so-so health, but I want to be as healthy as a healthy person without diabetes. Will I achieve that? Probably not to the degree I’d like but I believe in striving for the best possible outcome, so that when I fall a little short, I’ll still be in a great place and proud of my efforts.

So how did I compartmentalize? Well, I started to read these harrowing news stories almost as if I was outside of my body and I didn’t personalize anything of the data for myself. For example, if I was looking at how many people with type 1 diabetes suffer kidney damage after a certain number of years with type 1, I did not allow myself to apply that to my many years with type 1. I basically pretended I didn’t have diabetes while I read and wrote about this. It sounds robotic, and it certainly kind of is, but my sanity is crucial to my overall health so I needed to get through the information, log it into my brain, and keep it there as pieces of useful data available to guide or influence my future decisions.

Now for the real important bit–attacking fears with action. The best way I know of to feel more in control and more motivated about a situation is to act on it. Action needs to be fueled by knowledge and caution, of course, but action is THE catalyst for any positive outcome we might enjoy. No one ever lost weight by thinking about it or wishing for it.

Here’s the dialogue that plays out in my brain:

What is my fear? That i’ll develop any number of complications.

What causes diabetes complications? If I’m going to generalize and I am, it’s high blood sugars both acute and prolonged over time.

So what should I do to manage my fear? Avoid high blood sugars.

How do I avoid high blood sugars? For about 8.5 years i’ve written about Dr. Bernstein and his low carb recommendations for people with type 1 diabetes. I’ve lowered my carbs gradually over the last 13 years and seen much fewer highs as a result. I’ve continued my efforts to the point of following a very low carb diet in a more consistent manner and i’ve seen even fewer episodes of high blood sugar and fewer episodes of low blood sugar, too. Also, the catastrophic highs and lows are nearly non-existent.

Fewer highs and lows have literally been the remedy to my fears. Now, I still have fears about certain aspects of this condition and I get tired of living with diabetes, but just like any human, I can’t expect to live without fear, I can only hope to manage it in a way that lets me accomplish what I want and be happy with my life.

Each time I read or write about diabetes, I keep it impersonal but I save the information away to use when I need motivation or information with which to make a decision.

I hope that you, too can consider new information carefully versus letting it alienate you from something that might help. Don’t be afraid to talk to a healthcare professional about what you read, too. Some studies are not as reliable as they seem. Others are funded by the very companies that stand to make a profit.

Remain skeptical but don’t turn away from information–it might be just what you need.

Too often, I have worried about my health, let questions swim around my head and neglected going to the doctor to deal with my concerns. I know why I’ve hesitated. It has to do with two simple things: fear and money.

Fear is so powerful a motivator but it isn’t a positive one. To neglect one’s health due to fear is generally to encourage a more negative outcome based on putting off something important. For example, the person with diabetes avoiding their annual eye exam may create a more frightening scenario when they finally go and find out they would have been better off knowing about a treatable eye issue while it was easier to treat and while their vision wasn’t yet compromised. I did this the year before last and when I went to the doctor a few months ago, basically shook in my boots over what she was going to find in my eyes. I was lucky–this time.

Money is not just a huge motivator, it’s a stubborn deterrent. If I can’t afford something, I can’t afford it, right? Thanks to credit cards, more of us are managing to get our insulin, strips, and doctor visits in but we are psychologically crumbling at the rising debt caused by affording what we need, knowing that we are further in the hole. I posted a while back about how much I spend on healthcare outside of my premium each year on my diabetes. That was just a few years ago and the number has not doubled or tripled, it has quadrupled since then. My family income hasn’t quadrupled so good luck to us. I’m not the only one trying to choose healthier versions of food, better insulin, adequate strips, and regular doctor appointments. I know many of you are struggling with the same and it is frustrating. We have to make some hard choices don’t we?

So how does one cope with these realities and still feel like we are in control of our health?

I don’t really know but I can tell you what I do to feel as close to that as possible.

First thing I do is make a list of my concerns and questions. I try to get as many of those as possible met at doctor visits. I ask my husband to help me make sure I go to the doctor. I think of my children and how they need me to be well and I push through and make sure I don’t neglect getting my questions answered and concerns dealt with. I go to the doctor with a list of things so that I don’t forget anything. Pushing through fear ends up feeling better than cowering at it.

Then I create a list of things to do each day that support my goals. Eating healthy, exercising each day, getting enough sleep and water, checking my blood sugars and taking my insulin–these are all non-negotiable. I have to be that person who loves spontaneity but who puts her foot down and tells people, “Sorry, I am not available at that time of the morning because that is when I work out.” Or “No, I can’t get a drink, I have to get to bed, maybe tomorrow at an earlier time?”

When it comes to finances, I also have to put diabetes and health first. So I budget diabetes and health items in like a car payment or the mortgage and try to have the mentality that these things are more important than even a mortgage. Wine and entertainment may seem like necessities but aren’t really. Those things get pushed back if needed. No it’s not fun… yes it is worth it.

The thing with discipline is that even though it seems really boring and restrictive, it doesn’t have to be. It can be the most empowering and noble thing in the world because of what we can accomplish through this discipline (and how we are the recipient of all the earnings). And you don’t have to suffer if you don’t choose to. Suffering due to our own choices can be very minimal or even non-existant because we are in control and no one is the boss of us and we aren’t blowing aimlessly in the wind like my blood sugars after a pizza and dessert.

Sure I mess up and throw off my health from time to time with poor choices. However, each time this happens I’m only more convinced that my disciplined routine is wonderful because it is what gives me the feeling I imagine healthy non-diabetics have: to feel decent most of the time. How marvelous it is to feel decent most of the time. With diabetes and without discipline, feeling decent most of the time isn’t possible (unless you are special and not like me). Think of how much you can do when you feel fine most days and can carry on with work, family, friends, and fun?

I’ve spent about half of my whole life feeling crappy and that is why I’m so enthusiastic about taking control of my health, despite the challenges. I deserve to feel really good and so do you!

If successful diabetes management is based upon a multitude of decisions we make during the day, why is technology often regarded as the number one asset in our diabetes management arsenal?

It can’t possibly be. Take some important daily decisions that all impact diabetes:

-what to eat

-when to eat

-how much to eat

-how much insulin to give

-when to give insulin

-when to exercise

-what type of exercise to do

-how much to exercise

-when to test blood sugar

-how often to test blood sugar

And on and on!

Now basic technology like a meter is huge. But, only if we choose to use it. And a pump, for many of us, makes it easier to eat and deliver insulin as needed and to do a wide variety of exercises, as long as we choose to use it properly. A CGM gives us information about trends and helps us catch highs and lows before they get too high or low. Not to mention it can help save our lives by alerting us to dramatic blood sugar levels.

So technology is awesome!

That’s indisputable.

It would seem that those using all of this technology would always have better diabetes management than those who only use a meter and syringes, right? And yet, in my personal experience, I’ve met many people who use a meter and syringes and do very well and people who use all the technology available and don’t do very well.

There are other important variables that always need to be considered. So when a person is struggling with their diabetes management, often times more questions need to be asked than what is often asked. Most likely, a person who can do well with a pump, can do well without one. And CGM’s are most dramatically beneficial to those who can’t feel their lows or have young children with diabetes.

My cautioning is really about avoiding the conclusion that, “If I had a pump, my diabetes would be controlled” or “I probably just need a CGM to have controlled blood sugars” without considering other factors. This isn’t to say these tools won’t dramatically help one’s management. There is no guarantee and the decisions a person takes throughout the day is a better indicator of how a person will do with diabetes technology.

So if you’re struggling with your diabetes management, assess the root of your individual struggle. Some people’s issues are best addressed with technology, but many issues are addressed outside of technology and skipping this facet of diabetes management can prove extremely frustrating and detrimental.

I know because I’ve been there, done that. Address your personal needs and let your blood sugars be your guide. What technology can’t begin to replace is you and your knowledgeable decisions, which require knowledge about your diabetes. Make sure your bases are covered before relying on gadgets.

Thank you for all the emails of concern over my blogging break this summer and fall. It was very nice to be missed. I’m happy to be back.

Over 6 years ago, when I ended my 7 year run with a Minimed insulin pump and switched to “the poor man’s” vial and syringes, I discovered something interesting about myself. I functioned better when I practiced minimalism. Not having so many balls in the air at once just feels easier. I don’t even replace my syringes or lancets but once every week and several months, respectively. I’ve never had an infection or any other problem as a result-at least not one I’m aware of. And this makes me feel a bit more streamlined in my diabetes management. I’m not saying I recommend being lazy about changing needles but practicing overall minimalism in my diabetes management works for me at the present time.

In the past, all my constant logging, pumping, and the checks and balances that goes along with that overwhelmed me into not doing anything well. Whereas now, I do the few essential things as well as possible, with A1c results I’m happy about. It may be my personality type or my lifelong struggle with anxiety but either way it’s true for me and we all need to work with what is true for each of us.

I’ve been travelling a lot lately and I’ve been amazed at how I can go days with just a small carry on bag and my purse and not even need all that I packed. And that includes carrying all my back up diabetes supplies which take up a good bit of room. The experience has taken away this fear I’ve always had where I ask my anxiety ridden self, “but what if I need it?!” Now I just think of how much nicer it is to get around the airport with a small bag and how quick and easy packing is. I’m less likely to forget something crucial, as well.

True and lasting change takes time and my moving towards minimalism has been a slow and deep process. For the first time I’m truly aware of how ridiculous our consumer culture is. I hate what we’re doing to the environment and ourselves. I notice my sense of calm when I go somewhere that is totally uncluttered. I can think and focus better in that environment. I also have learned that more stuff does in no way translate to more happiness. Though I can admit that being above the poverty level and therefore having sufficient safety and health affirming opportunities is important and absolutely impacts happiness levels. But if we only refer to extras, I just spent the summer in a huge house at a lake paying zero in rent and I felt depressed the whole time.

My favorite thing since childhood has been the computer. I don’t know how many kids had a computer at home in 1993 but I did. I saw the potential of this great mysterious box and as they took off better and better every minute, I became only more grateful that I had been born at a time when the world was at our fingertips. Not to mention accessing information that was more real time than a book was super exciting. Like most people, I love learning and the age of the internet has been my greatest ally, especially as a drop out college student married to a drop out college student. We haven’t been hindered by our drop out status in terms of knowledge (unless you beg to differ) and that’s a righteous equalizing factor. (Though in job searching we all know a degree still outweighs so many other valuable assets and qualities but that is a discussion for another day).

Part of what being globally connected has done for me is give me a very real view of how others think and live. And it’s been impossible for me to ignore the fact that we have enough resources for all humans to have all they need. We just don’t have enough for all of our wants. Suddenly I feel greedy and I welcome that feeling because I don’t want to be talked about by my great grandchildren as the stubborn old woman that was gratuitously a part of a careless, destructive, insensitive, and idiotic generation that put greed before humanity. I want them to know I was doing my tiny part to mitigate damage in my own home, community, and country. I want them to know that I didn’t carry the attitude of a victim, of someone who says, “well, what do ya do” or “if you can’t beat em’, join em’”. Bull. Bull! I want my grandchildren and great grandchildren to know that I felt guilty about how I was living and motivated and inspired by others to act and make any change I could to make something, anything, better.

And that leads me to where I feel I’m now more quickly headed. The movement of minimalism is becoming more popular. Now there are those who criticize minimalists for being trendy. But I’m glad it’s catching on and truthfully, it’s being criticized because every time someone talks about it we are basically causing others to self reflect and to feel that we are rejecting much of society. It’s not like my life’s goal was to reject much of society. It’s actually in my nature to agree with you as much as possible. But self reflection and awareness has put me here.

Anyway, what’s great is that there is no right way to practice minimalism The key is to be aware, to be conscious of how we live and to make changes where we can. To reject it is fine. But there are consequences. That’s just a fact. I no longer feel comfortable living the way most do in the US. That doesn’t mean I judge you for not feeling the same way. It just means that we should all be discussing this and supporting each other. In other words, I tell you about my minimalism journey and stop right there and you tell me about all your shopping trips and stop right there. I don’t tell you you’re doing something wrong and you certainly don’t tell me I’m nuts for trying to live with a lot less. This has been a very recent change for me and even now I still waste paper towels like nobody’s business so I don’t have room to judge. I do like talking about it because that’s how I got introduced-by others talking about it with me or writing about their experiences with it. I am so thankful for their time and willingness to share how and why they do what they do.

So what is my family doing now?

Well, first of all, I’ve been getting rid of a lot of material goods this year. It stung for a second and then I forgot I ever owned any of it.

I also grabbed a few items by the dumpster and refurbished them with my husband. He fixed them up and I painted them-which turned out to be some of the best meaningful fun I’ve had all year.

Our cheap dining room table set broke years ago and we couldn’t afford to replace it so Alex (my husband) made a farmhouse style table with simple benches and together we stained it teak and Caribbean blue. The entire project cost less than $100 and we are so proud of our table. Our children loved witnessing planks of wood turn into something so useful.

I’ve been scanning and backing up documents in order to free ourselves of paper weight.

We sold our second car super cheap in an act of charity and just go everywhere together. This works well for us because Alex drives a company truck to and from work.

My brother in law gave us his TV but we still don’t pay for cable TV, instead we use Netflix or Hulu to watch TV using the WII my husband received as a gift. It’s cheaper and we spend a lot less time in front of the TV.

We just bought a 900 square ft house with no basement or functional attic. My son and daughter will share a bedroom, which is going against the norm unless you go to other parts of the world where entire families eat, sleep, and entertain in one room. We hope to have a smaller footprint that way and to be forced into not buying so much stuff because, “where on earth would we be able to put it?”

Alex and I have never had credit cards. And when there is extra money, we’ve paid off tuition, medical debt, whatever we can, instead of taking a vacation. We haven’t had a vacation since our honeymoon 5 years ago but there is definitely less stress in paying things off when possible. When people say “you can afford that” we say, “no we can’t” And it’s a dignified, “no, really, we can’t and don’t want to be burdened with debt, be irresponsible with money, or give in to the seductive pleasure of mindless shopping and imaginary needs.” And I am just like anyone else. I get cheered up by buying things. I love clothes. I love books. I love STUFF. I have fooled myself into believing I can heal my anxiety with a shopping trip. But, what I’ve learned is it’s a temporary fix. And then I’m back to where I started, only, with less money.

We try to eat very simple whole foods with few ingredients just to make preparation and clean up that much easier. We are slowly getting rid of kitchen supplies. It’s a little scary but eventually we want to just have a bowl, spoon, fork, and mug for each of us and just wash after every use. No more piles of dishes! I know that sounds crazy but if you come over I will have delectable finger foods for you, great wine that we’ll drink out of, I dunno, something, and fun conversation-all to distract you from our primitive approach. I’m trying to make my new mantra, “people, not things”.

We plan on growing some of our own food. There will be a major learning curve but, we are committed to giving it a good shot.

We plan on homeschooling the kids which will help us with having a more pleasant schedule and less hectic times throughout the day. Less stress is always a plus. Additionally, it has been brought to my attention that right now, the greatest indicator of a child’s outcome in school is their family income and not their performance or work ethic or testing ability. I’m not playing that game. If we can manage and meet everyone’s needs then we’ll do it, if not, then we’ll try something else.

I have been slowly getting rid of clothes. I noticed a while back that my husband is always better dressed than me and I think it’s because he sticks with a simple routine: button up shirt or polo, khakis or jeans, leather shoes-and done. He gets colors that he likes and he gets high quality so he can use his clothes for years. So I’m trying to simplify my dressing by getting rid of everything that isn’t awesome on me (because, really, why do I want to wear anything that looks less than awesome on me?) As a result, I’ve gotten rid of 75% of my closet! But, it feels great and laundry is sooo much easier! I’ve heard of people who own two pairs of pants and two t-shirts and that’s all they wear and it sounds amazing but I’m definitely not there, yet.

I’ve discovered the magic of Goodwill. It’s hit and miss and I’ve learned you have to be picky, but people have been amazed by what I get from there which cost next to nothing. The key is to make sure it serves a strong purpose and doesn’t add to clutter, something I should write on my hand before my trips there.

Well that’s it, I think. Again, these aren’t things anyone else should do, this is just what we feel we can do and we have a long way to go but it’s a process. We’re just going to do what feels right.

A part of me does feel like I’m making a statement with my minimalist diabetes management approach. I want to be an example to those with limited resources and say, “you can do it with the basics, and do it well.” A lack of money absolutely harms health but just enough money is another story. I have just enough money for the basics which does include sufficient test strips for each day-excellent blood sugar control is not up for discussion. I don’t need a pump or continuous glucose monitor, though it’s relative isn’t it? If I die tomorrow of a middle of the night low blood sugar everyone will say I did need it. But, if I die tomorrow in a car accident, you could say that I needed perhaps a different car or that I needed to have taken a better route or skipped a dumb errand. If I die from a stroke, you could say I needed to have changed some part of my lifestyle or taken some type of medication. The point is with so many variables each day affecting our well being it’s just not cut and dry. I feel that my very simple approach forces me to maintain an important discipline that extends into all parts of my life. That discipline is ultimately responsible for my diabetes management and how well it goes. And that’s what I really wanted to share today

Do you practice any kind of minimalism? If so, I’m interested in learning more, please share in comments.

Some people are perfectionists. I have a little of that. As a result, I beat myself in the head with thoughts having to do with self improvement and practice makes perfect and try again until it’s right and so on.

Because of this tendency I find that I can easily go to extremes. About losing weight, I have a hard time keeping reasonable thinking like, “I want to lose 5 pounds.” Instead it’s “I want to be thin like I was at age 10”. Or instead of thinking “I need to eat more vegetables” I may think, “I’m going to eat nothing but vegetables from now on until the end of time”.

I don’t actually stick to those extremes thank goodness, but it’s a nagging tendency that isn’t healthy and certainly not comfortable.

Something I learned at IIN, where I graduated recently, was to sometimes “be bad”. Not go-to-jail bad, but stop-striving-for-unobtainable-perfection bad.

So I’ve found that when I get wrapped up in thinking that I will never eat another bite of anything unhealthy again, I plan for a night with a little ice cream.

Or recently, I got myself some clove cigars that I really like and have one when I’m feeling like all the “right” choices are kind of stifling me with boredom.

It’s hard to try to be “good” or “compliant” all the time and with pretty well managed diabetes, that’s what it feels like. I mean, I give insulin to bring down a 130. To me, that kind of control is worth it, I truly believe so, but to balance all that I sometimes sleep in my makeup, smoke the occasional cigar, skip a shower, or read the Fifty Shades Trilogy (yes, I read that marvelous piece of literary crap. In three days. My world stopped for a week. Don’t worry about me I’ve recovered. Team Matt Bomer!).

Being “bad” reminds me to chill. It also makes me realize that if my idea of being bad is sleeping in my makeup, then I think I’m going to be ok.

I buy a quart of juice each week and the kids get a few drops of it in their cup of water so that it’s flavored. We went to a local university to enjoy the nice fall weather recently and when I realized that I forgot to buy glucose tablets, I just packed that unopened quart of juice in the car for any emergencies.

Earlier that same day, my parents let me know they were stopping by. I took a look around me and knew I’d have to speed clean in order to make the house presentable. So I whipped the kitchen, living room, and guest bathroom into shape in 30 minutes. This is something that would have normally taken me 2 hours.

I was sweating after it all and almost out of breathe (not sure what that says about me).

And a little after that is when we went out to walk. And that’s when I was thankful for that entire quart of juice I packed in the car. I needed every last drop totaling 96 grams of carbs. Two hours later I was 83 and in desperate need to pee.

I think this was a great reminder for me. When I ponder choosing between a workout and cleaning the house, why not combine the two? One and the same if you move quickly and deliberately.

Here’s my story-I used to get very caught up with how I was going to afford my diabetes medications and supplies. I would make a yearly budget list of things I wanted to spend money on and I would include all my diabetes stuff on that list. Then throughout the year I’d make choices from that list as money came in. I ended up putting off my diabetes related purchases until the last moment or until I was broke and had to ask my parents for a loan.

This was no dignified way to live. I felt upset every time I did spend money on my diabetes thinking, “This is so unfair, with what I spend on my diabetes, I could have gone to Europe for a month by now!” And perhaps that’s the truth. BUT…didn’t I have a high value placed on my health? Didn’t I realize diabetes wasn’t going to go away and that if I was healthy, I was able to do more things?

I began realizing that my diabetes related purchases needed to be on a list of things that I must spend money on. And in fact, those purchases needed to be at the top of the list because health really should be my priority.

I was bitter for years because I was giving up small vacations, clothes, cds, and other things I wanted to buy because that extra money was going to my diabetes. I didn’t like feeling this way so I started working on changing the way I thought.

I realized I was choosing to be miserable, yet healthy when I could choose to be content and healthy. So I decided to continue prioritizing my diabetes but I also began working towards a goal of getting a new job and making more money. In the meantime, I’d try to take pleasure in the simple things like friends and family and focus on what I DID have.

Eventually I got to where I’m at now. Paying for my insulin and strips is just like paying the monthly rent. I don’t even think about it. I need it. I’m grateful to be able to pay for it. And instead of being upset about it, I’m spending that energy on much better things.

In the end, it’s all worked out better than I ever dreamed. Some people cannot afford their diabetes supplies. Some don’t have the choice. For those of us who do, let’s make it in favor of our health and the rest will fall into place.